Provider First Line Business Practice Location Address:
BO MONACILLOS CARR 22
Provider Second Line Business Practice Location Address:
CENTRO MEDICO ASEM
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00935
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-247-4496
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/06/2006